20200930133330 20200930133330 Selcuk Medical Journal sinandemircioglumd@gmail.com Prof. Dr. Sinan DEMİRCİOĞLU Selcuk Medical Journal Selcuk Med J 2149-8059 09 30 2020 22 3 Mehmet Şeneş AYSEL KIYICI Aim: Many different methods have been used for detection of antiepielptic drug concentrations for many years in clinical chemistry laboratories. In our study we aimed to evaluate the performance of turbidimetry as a method for detection of serum antiepileptic drug concentrations by comparing it with HPLC technique. Material and Method: Measurements were performed in both methods teknion the blood samples of the epileptic patients who were in follow up in neurology and pediatrics clinics of Ministry of Health Ankara Education and Research Hospital. This study was carried on laboratory of biochemistry of the same hospital. 35 samples for carbamazepine, 31 for phenytoin and 30 for phenobarbital were taken into this study. Results: Within run CV values for HPLC technique in measurement of sera were as follows for each drug: Carbamazepine 1.57% and 3.62%; phenytoin 2.15% and 4.14%; and phenobarbital 1.53% and 4.34%. They were found in turbidimetric method as follows: Carbamazepine 2.66% and 7.03%; phenytoin 1.98% and 2.04% and phenobarbital 3.3%1 and 5.24%. There was a significant correlation between turbidimetric method and HPLC technique (for carbamazepine r= 0.95, phenytoin r= 0.97 and phenobarbital r= 0.86 ). The recovery rates for each drug in turbidimetry were satisfactory (carbamazepine R%= 80.4%, phenytoine 88% and phenobarbital 86.8%).They were as follows in HPLC technique: R%= 105%, 107%, 110%. Conclusion: HPLC technique is accepted as a reference method for detection of serum antiepileptic drug concentrations. The performance of turbidimetric method is weak when compared with HPLC technique. But because of the cost effectiveness and the short turn around time, turbidimetry was preferred in our country. 09 30 2020 91 95 https://selcukmedj.org/en-us/the-comparison-of-hplc-and-turbidimetric-methods-in-the-measurement-of-serum-antiepileptic-drug-concentrations-en-5783/ https://app.selcukmedj.org/uploads/makale-pdf/the-comparison-of-hplc-and-turbidimetric-metho.pdf İhsan Hakkı Çiftçi Nihal Kıyıldı MEHMET ÜNLÜ MURAT SEZER Fatma Fidan Aim: We aimed to determine the prevalence and risk factors of asthma and atopic diseases in preschool education centers in Afyonkarahisar. Material and Method: Of the 1288 children in 41 preschool education centers in Afyonkarahisar, 1084 children, whose parents have approved the study, were accepted. A standard questionnaire interrogating sociodemographical status, presence and risk factors of asthma and atopic diseases was filled by the parents of the children. Results: The mean age of 1084 children was 5.7 ± 0.7 (3-6), 505 (46.6%) of them were girls and 579 (53.4%) were boys. The prevalence of asthma was 3.1%, allergic rhinitis 5.0% and eczema 1.8%. Presence of asthma or an atopic disease in the family was significantly higher in the group with asthma (44.1%) than without (25.5 %)(P=0.015). Intake of breast milk in the infancy was significantly low in the group with asthma (P=0.039). Presence of an allergic disease in the family was found to cause a 2.3 folds and absence of breast milk intake a 2.7 folds increase in the risk for asthma. In the children with asthma, wheesing and allergic rhinitis frequency was significantly high. While there was no difference in froguency of eczema. Conclusion: Presence of an allergic disease in the family and a bsence of breast milk intake in the infancy was found as significant risk factors for asthma in 3-6 age children in pre-school education centers. 09 30 2020 97 102 https://selcukmedj.org/en-us/prevalence-and-risk-factors-of-asthma-and-atopic-diseases-in-pre-school-education-centers-in-afyonkarahisar-en-5784/ https://app.selcukmedj.org/uploads/makale-pdf/prevalence-and-risk-factors-of-asthma-and-atop.pdf METİN BİRCAN ABDULLAH GİRİŞGİN BAŞAR CANDER Hasan Hüseyin Kozak MEHMET GÜL Aim: The aim of this study was to contribute to the data about the ischemic stroke epidemiology. Material and method: We analyzed 99 patients with ischemic stroke regarding the stroke risk factors. The patients and the controls were compared in respect to stroke risk factors. Results: Hypertension, atrial fibrillation, and cigarette smoking was statistically significant as a risk factor in the stroke group compared with the control group (P0.05). 09 30 2020 103 106 https://selcukmedj.org/en-us/the-evaluation-of-risk-factors-in-ischemic-stroke-en-5785/ https://app.selcukmedj.org/uploads/makale-pdf/the-evaluation-of-risk-factors-in-ischemic-str.pdf Deniz Akata Tuncay Hazırolan Faruk Köse Enis Özyar Lale Atahan ÜLKÜ KERİMOĞLU Aim: To assess prospectively the role of resistive indicies (RI) in determining the response to radiotherapy by transvaginal color doppler ultrasound (TVCDUS) and to correlate the results with MRI findings. Material and Method: 13 patients with advanced stage (>stage IIA) cervical cancer evaluated by MRI of the pelvis and TVUS before and 6 months after radiotherapy treatment. The mean resistive indicies before and after daiotherapy were measured from the periphery and the center of the tumor and were compared. These values were further correlated with both MR findings and RI values of the control group. Results: B mode TVUS identified the mass of all patients before therapy. RI measured 0.20-0.82 (mean=0.52) and 0.70-0.99 (mean=0.81) before and after the radiotherapy respectively in 13 patients. 11 showed full response clinically and accordingly, MR showed no residual tumor. MR examination and US showed residual tumor in two patients. The increase in RI before and after the radiotherapy was statistically significant (p=0.001) in the full response group. RI did not increase in two patients with residua. The mean RI measured from the control group was 0.65 and was significantly higher than the RI of the patients measured before therapy. Conclusion: Spectral features of TVCDUS can be a good alternative in the follow up response of cervix carcinoma to therapy, since a significant correlation between MRI findings and RI measurements are found. 09 30 2020 107 115 https://selcukmedj.org/en-us/sonographic-evaluation-of-radiotherapy-response-in-cervical-cancer-correlation-of-mri-findings-with-resistive-indices-en-5786/ https://app.selcukmedj.org/uploads/makale-pdf/sonographic-evaluation-of-radiotherapy-respons.pdf Ender Gedik Mehmet Özcan Ersoy HALE BORAZAN Aim: In this study, the aim is to determine the effects of BIPAP on alveolar gas exchange and haemodynamics over BIPAP + PSV mode in acute respiratory failure. Material and method: After sedation, 50 patients with acute respiratory failure were ventilated. BIPAP was preferred for first six hours and 10 cmH2O PSV was added on BIPAP for the second six hours. Mean arterial pressure (MAP), heart rate (HR), inspiratuar pressure (Pinsp), peak pressure (Ppeak), plato pressure (Pplato), mean pressure (Pmean), minimum pressure (Pmin),intrinsic PEEP (PEEPi,) total minute volume (MVtop), spontaneous minute volume (MVspo) and ratios, total frequencies (ftop), spontaneous frequency (fspo) and ventilatuar frequency (fmek), inspirium ve expirium tidal volumes (VTinsp, VTeksp), resistans, complians, arteriel blood gases values, FiO2 values and Horovitz ‹ndex (PaO2/FiO2) were recorded at, T1: initiation of ventilation, T2: end of the BIPAP ventilation, T3: end of BIPAP + PSV ventilation. Results: There was no statistically difference in haemodynamic data, Ppeak, MVtop, VTinsp, VTeksp, airway resistance, compliance, PaCO2, SaO2 ve PaO2 values. The increase in spontaneous respiratory rate and decrease in Pinsp with BIPAP + PSV mode was statistically significant (p<0.05). Arterial blood gas analysis with BIPAP + PSV ventilation, FiO2 levels were reduced while Horovitz index values were increased (p<0.05). Conclusion: BIPAP and adding 10 cmH2O PSV provide positive effects on oxygenation. We think that the effects of this kind of hybrid ventilation should investigate at homogenous subgroups and long term ventilation. 09 30 2020 119 126 https://selcukmedj.org/en-us/-en-5787/ https://app.selcukmedj.org/uploads/makale-pdf/-akut-solunum-yetmezligi-bulunan-hastalarda-bi.pdf MEHMET PİŞKİN Mustafa AVUNDUK Talat Yurdakul Aim: To present a squamous cell metaplasia of bladder which is induced by a rarely seen pathology called recurrent eosinophilic cystitis. Case report: Twenty four years old female patient, admitted to our clinic with frequent urination, suprapubic pain and dysuria. Microscopic hematuria was found in urine analysis. We performed cystoscopy under general anestesia and an edematous, ulcerative lesion located at the trigone was found. The lesion was resected transuretrally. Pathology revealed eosinophilic cystisis. The patient began antihystaminics and aniticholinergics. The symptoms of the patient relapsed 2 months after medical treatment. This time the cystoscopy revealed a similiar lesion in a different area than the first one. The lesion was resected transurethrally. The biopsy revealed squamous cell metaplasia of epithelium and eosinophilic cell infiltration. Patient began steroid and antihistaminic combination postoperstively. The patients has been followed up to 6 months without any symptom. Result: Medical treatment is effective in the control of reccurencies of eosinophilic cystitits. Recurrent eosinophilic cystitis might cause squamous cell metaplasia in the bladder mucosa. 09 30 2020 127 130 https://selcukmedj.org/en-us/squamous-cell-metaplasia-of-bladder-induced-by-recurrent-eosinophilic-cystitis-en-5788/ https://app.selcukmedj.org/uploads/makale-pdf/squamous-cell-metaplasia-of-bladder-induced-by.pdf HÜSNÜ ALPTEKİN Aim: Gastric diverticula are uncommon and usually asymptomatic. Only one case of pyloric obstruction secondary to a gastric diverticulum was published in the literature. A case treated for pyloric obstruction secondary to a gastric diverticulum and the related literature are reviewed. Case report: The 66-year-old female, treated for peptic ulcus along three month, consulted to our hospital complaining about vomiting after eating something for last 15 days. Having examined upper gastrointestinal system, diverticulum was found on at lesser curvature, located adjacent to and partially including the pylor. Patient was treated with endoscopic balloon dilatation. Conclusion: Even if simple resection was suggested for symptomatic gastric diverticula, pyloric stenosis secondary to a gastric diverticulum can be cured with endoscopic balloon dilatation was reosanable. 09 30 2020 131 134 https://selcukmedj.org/en-us/pyloric-stenosis-secondary-to-a-gastric-diverticulum-en-5789/ https://app.selcukmedj.org/uploads/makale-pdf/pyloric-stenosis-secondary-to-a-gastric-divert.pdf BAYKAL TÜLEK Aim: Respiratory muscle weakness is the inevitable consequence of many neuromuscular disorders. Deterioration in respiratory function contributes to significant morbidity and is responsible for high mortality rates with these diseases. The aim of this review to summarize diagnostic and therapeutic approaches for respiratory problems in patients with neuromuscular disorders. Main Findings: Usually, chronic respiratory failure develops slowly over a period of several years. Initially, it presents with disordered breathing that is apparent only during sleep, followed by continuous progression to severe hypoventilation, cor pulmonale and eventually frank respiratory failure in end-stage disease. Early detection of respiratory compromise and preventive care are likely to improve outcome and quality of life for many patients. This has led to the development of proactive monitoring and treatment programmes that include regular assessment of pulmonary functions, respiratory strength and sleep studies, home mechanical ventilation, chest physiotherapy, early antibiotic treatment and nutritional intervention. In particular, noninvasive positive pressure ventilation is effective in resolving respiratory failure and has dramatically changed the management of these patients. Conclusion: Pulmonary functions and sleep related respiratory problems should be followed up regularly in patients with neuromuscular disorders. Noninvasive mechanical ventilation is the most important therapeutic option for the management of respiratory failure in these patients group. 09 30 2020 135 144 https://selcukmedj.org/en-us/respiration-in-chronic-neuromuscular-diseases-en-5790/ https://app.selcukmedj.org/uploads/makale-pdf/respiration-in-chronic-neuromuscular-diseases-.pdf